A form of spinal fusion in which the surgeon approaches the spine from the back of the patient’s body, posterior lumbar interbody fusion is used to join the lumbar (lower back) vertebrae of the spine in order to maintain the integrity of the discs of the area (the last five vertebrae of the spinal column). The procedure is used to alleviate painful conditions resulting from spondylolisthesis, spinal stenosis, a deterioration of discs of the spine or when a patient needs to have multiple discs removed.
After the standard pre-operative steps are taken, a surgeon makes an incision in the lower back and moves aside muscles, tissues and organs, giving a clear path to the lumbar region of the spine. The damaged disc or discs are removed and the surgeon then determines what size the graft will need to be in order to properly fill the space left by the removed discs. The graft (pieces of bone in a metal cage) is then implanted into the space to realign the vertebra and alleviate any impact to nerves. This is often enough to stabilize the remaining vertebrae, however a surgeon may also implant rods and screws if deemed necessary for support during healing.
Now, as the patient heals, the graft of bone will, ideally, grow around the implant, restoring normal function to the lumbar region of the spine. Three to four days after surgery patients are usually discharged with recommendations for physical therapy exercises that can prevent reinjuring the area during the healing process. These recommendations will help with everyday movements and mobility (walking, lifting, bending etc.) that may be started four to six weeks after surgery, at which time any post-operative pain should have subsided.
As with all back surgeries there are complications: during and after the recovery period the implanted graft may shift or move from its proper location and the fusion of the vertebrae may fail, making additional surgeries a possibility.